NPI | 1609409580 |
---|---|
Former Name | HEATHER NICOLE LYNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104940) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 86520) |
163W00000X Registered Nurse (Licence: PA RN718107) | |
Enumeration Date | 2020-02-19 |
Last Update Date | 2020-02-19 |